Providing custom orthodontic treatment with appliance components from inventory

ABSTRACT

Computer analysis is made of individual patient related data in order to select standard or pre-manufactured orthodontic appliances or appliance components ( 10 ) that are most likely to provide orthodontic treatment suitable for the individual patient. This analysis can be made by the software of a custom orthodontic appliance designing system, without actually manufacturing the custom appliance. Geometric parameters ( 21 - 24, 28, 29 ) of a custom designed appliance may be compared with corresponding parameters of alternative standard appliances or appliance components so that the closest standard component can be used. The custom appliance can be designed to accommodate the geometries of one or more appliance components. Where custom mounting instructions that modify otherwise standard installation of an appliance or component will render the standard component more compatible with a custom appliance design, such instructions are provided to the orthodontist along with the selection. The invention is most useful in selecting orthodontic brackets, or combinations of standard brackets and standard archwires.

This application claims priority to U.S. Provisional patent applicationSer. No. 60/385,178, filed May 31, 2002.

FIELD OF THE INVENTION

This invention relates to orthodontic appliances and to the selection ofcomponents for such appliances to provide treatment suited for theparticular patients.

BACKGROUND OF THE INVENTION

Orthodontic appliances are hardware devices that are attached to theteeth of patients, usually by orthodontic practitioners, to movemalocclused teeth to better positions to improve the functionality ofthe teeth and the appearance of the patient. For decades, the mostcommon orthodontic appliances have been formed of orthodontic bracketsor bands that are secured to the patient's teeth and which areinterconnected by an elastic archwire. Forces are applied by thearchwire through the brackets and bands to the teeth to move them towardthe desired positions.

The initial shape of the archwire for the treatment of a particularpatient is generally prescribed by an orthodontist. Typically, the wireis bent during treatment so that the forces it applies affect theintended movements of the teeth. Intelligent selection of brackets andarchwires, or other orthodontic appliance components, by theorthodontist can lead to more efficient treatment and require lessmanipulation of the appliance by the orthodontist during the course oftreatment of the patient.

Systems and methods for providing custom orthodontic appliances aregaining acceptance. These systems and methods take into accountindividual patient anatomy in designing and manufacturing the customappliances on a case-by-case basis. Often, custom appliance designs arebased on calculated ideal occlusions or treatment plans by or with theaid of computers or computer programs. The computers determine toothsetups or post-treatment tooth positions based on digital data of thetooth shapes and other dental anatomy of the individual patients. Theresulting custom appliances, when properly designed and made, can beinstalled on the teeth of a patient by an orthodontist, usually usingcustom jigs or other positioning devices or techniques that may beprovided with the custom appliances to insure placement of theappliances at predetermined positions on the teeth of the patients sothat the appliance functions in the way for which it was designed.Properly installed, such a custom appliances can move the teeth ofpatients in less time and with a minimum of post-installationmanipulation by the orthodontic practitioner. Systems and methods forproviding custom orthodontic appliances are described, for example, inU.S. Pat. No. 5,431,562 and in PCT Publication No. WO01/47405, bothhereby expressly incorporated herein by reference.

The manufacturing of a custom orthodontic appliance may not always beavailable or might not always be desired, either because of the cost orbecause the orthodontist might require appliance components or a specialprescription that the automated custom appliance manufacturing systemmight not be equipped to provide. In such cases, manual selection ofappliance components is made by the orthodontist from availableinventories of standard or otherwise pre-manufactured components, whichthe orthodontic practitioner assembles to form the appliance to treatthe patient.

Selection of pre-manufactured appliance components by an orthodontistusually involves a consideration of the patient's individual anatomy,which can include skeletal and soft tissue anatomy as well as dentalanatomy. This consideration leads to a prescribed treatment plan.Traditionally, such determination by the orthodontic practitioner of atreatment plan involves certain estimations, based on the judgment andexperience of the practitioner, by manually applying professionallyaccepted criteria. The orthodontist then typically selects an appliancedesign that will achieve that treatment plan, which may include pickingindividual archwires and brackets from inventory or from a catalog thatwill form an appliance to carry out the prescribed treatment.

Such selection of appliance components is time consuming for theorthodontist. The manual techniques currently employed lack thecapability for making the most accurate analysis of the patient'sanatomy and the best selection of appliance components. Accordingly, aneed exists for improving the selection of pre-manufactured appliancecomponents and for better approximating the features of a customorthodontic appliance most suitable for treating an orthodontic patient.

SUMMARY OF THE INVENTION

An objective of the present invention is to provide orthodonticappliance components that are well suited for carrying out a customorthodontic treatment plan for an orthodontic patient.

A more particular objective of the invention is to facilitate theselection of pre-manufactured or standard orthodontic appliancecomponents that will conform closely to the configuration of anorthodontic appliance that is custom to the anatomy of the patient.

Another objective of the invention is to reduce chair time for theorthodontist and treatment time for the patient by providing thefeatures of custom orthodontic treatment designed in a way that servesthe objectives of custom appliances, making their advantages availableto a degree, at least, to patients at a proportionately lower cost.

A further objective of the present invention is to provide a system andmethod for orthodontic treatment that will facilitate the selection ofstandard or pre-manufactured orthodontic appliances utilizing highlyaccurate, and economical automated appliance selection techniques.Particular objectives of the invention include providing the orthodonticpatients to be treated with pre-manufactured or standardized orthodonticappliance components with the precision and other benefits oforthodontic appliance design and providing such patients with theprecision and other benefits of computer assisted determinations of theideal positions of the teeth of such patients and the improvedorthodontic treatment results.

According to the principles of the present invention, an orthodonticpractitioner is provided with a service or with equipment or both toselect those optimal orthodontic appliance components that closely carryout a custom orthodontic treatment plan. Certain systems and methods,according to the invention, evaluate appliance components according toparameters of an orthodontic appliance design or treatment plan that iscustomized for a particular patient. Based on the evaluation, componentsare selected from those of a predetermined plurality of geometries asthose best suited for treatment of the patient. The evaluation andselection may be made, for example, by comparing component geometries ofa custom appliance designed for the patient with the geometries of thoseof the plurality, making the selection of components according tobest-fit criteria.

Systems and methods according to the invention may also vary the designof a custom orthodontic appliance for a patient in order to optimize thefit or matching of the custom appliance component geometries with thoseof the predetermined geometries. As such, the overall appliance is madeup of the selected components that use combinations of standard orpre-manufactured appliance components that best approximate the optimumoverall appliance or satisfy all of the relevant considerations andcriteria for appliance component selection. Such criteria andconsiderations may include cost, component availability, aesthetics,anatomical considerations of the patient, or other criteria that mightbe imposed.

Systems and methods according to the invention may also provide anorthodontic practitioner with information on the installation ofappliance components on the teeth of a patient in a way that bestfunctions as a custom orthodontic appliance or best accomplishes acustom orthodontic treatment plan.

Various computerized custom appliance design systems that are used tocalculate the custom appliances of various types, may be used to selectstandardized components from which an appliance may be assembled frompre-manufactured components, or components of predetermined geometries,from inventories or from shapes that can be efficiently manufactured toorder. Such systems may be so used for this purpose rather than for thecustom manufacture of an appliance or components of the appliance forthe individual patient on a case-by-case basis. For example, portions ofsystems that design custom appliances in the forms of series ofelastomeric positioners may be used to derive tooth finish positions forwhich components of bracket and archwire appliances, or appliances usingother types of components, may be selected. In addition, other dataanalysis services may be used to process anatomical data for use inmaking orthodontic appliance or appliance component selections.

According to one embodiment of the invention, a virtual or physicalimpression of the anatomy of a patient is communicated to a programmedcomputer. A physical impression may, for example, be shipped to anorthodontic appliance lab where a stone cast is made of the patient'steeth and scanned to produce three-dimensional or other data for inputinto a computer for analysis. The computer may also be located at theorthodontic practitioner's office or clinic. A scan may be made directlyfrom the anatomy of the patient, for example optically or by x-ray. Thescanned data may be preprocessed or input directly into the computer.The computer may then analyze the data. An orthodontic practitioner mayalso use third party services that produce three-dimensional or otherdigital files of the dental anatomy of the patient for transmission toanother facility for custom appliance design. A custom appliance designfacility may typically design an occlusion or case set-up ideal for thepatient, from which the design of a custom orthodontic appliance for thepatient may be made that would move the patient's teeth to their idealpositions. Selection of an appliance or appliance components fromavailable pre-manufactured items or from a discrete number ofpredetermined geometries or types may be made of those most suited toapproximate the custom appliance or to otherwise move the patient'steeth to the ideal positions.

As an alternative or an addition to the inputting of anatomical datainto the computer, treatment plan criteria may be articulated by theorthodontist, which the computer then analyzes. Such treatment plancriteria may include a prescription of orthodontic treatment that mayspecify, in part, final relative or individual tooth position ororientation geometry or may call for tooth extractions other propertiesof the desired positions of the patient's teeth or of the manner inwhich the teeth are to be treated.

Whatever data is analyzed by the computer, the computer may deriveparameters or characteristics of a custom orthodontic appliance or ofproperties that may be embodied in an appliance of custom design orconfigured to implement a custom treatment plan. The derived informationmay then be compared with stored geometric or other physical data ofavailable appliance components and a selection of components is made asa result of the comparison. The selected components may be those which,when assembled into an appliance and installed on the teeth of thepatient whose data was processed, replicates an appliance of a derivedcustom appliance design or that produces the custom treatment plan.

The analysis of the data may also take into account the parameters ofavailable appliance components and may conform the derived customappliance to a configuration that most effectively uses standard orother available appliance components. Several iterations may be made.The final component selection may be one that exactly conforms to thedesign of a custom appliance or that conforms substantially to a customdesign with minimum manual adaptation.

Where the selection of appliance components does not exactly conform toall of the criteria of a custom appliance or does not achieve all of theobjectives of a custom treatment plan, the analysis may generateinformation for installation or modification of the appliance by thetreating practitioner.

These and other objectives and advantages of the present invention aremore readily apparent from the following detailed description.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a diagram of a side view of a standard orthodontic bracketused to illustrate application of principles of the present invention,with one alternative group of geometric parameters marked thereon.

FIG. 2 is a front view diagram of the bracket of FIG. 1.

FIG. 3 is a top view diagram of the bracket of FIG. 1.

DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION

According to one embodiment of the invention, an orthodontist initiallyexamines a patient for the purpose of diagnosing malocclusion of thepatient's teeth and devising a treatment plan to correct themalocclusion. In doing so, the orthodontist may decide generally on thecourse of treatment and on the type of appliance to be used in thetreatment. A decision may be made by the orthodontist and patient toproceed with treatment using standard appliance components. Theappliance may, for example, be an orthodontic brace that includes upperand lower archwires to be supported on the respective upper and lowerteeth of the patient by buccal tubes fixed to tooth-encircling bandssecured to molars of the patient and by brackets bonded to the otherteeth of the patient with dental adhesive.

Such braces have traditionally been assembled by the orthodontist fromappliances or appliance components that are periodically stocked ininventory in the orthodontist's office. Brackets, buccal tubes andarchwires, for example, have been manufactured in various standard sizesand shapes by orthodontic appliance manufacturers. The orthodontistperiodically stocks the inventory by selecting and ordering them fromcatalogs and product bulletins of the manufacturers. Examples of suchappliances and appliance components are described in U.S. Pat. No.5,533,895 to Craig A. Andreiko et al. entitled Orthodontic Appliance andGroup Standardized Brackets Therefor And Methods of Making, AssemblingAnd Using Appliance to Straighten Teeth, in U.S. Pat. No. 5,474,448 toCraig A. Andreiko et al. entitled Low Profile Orthodontic Appliance andin U.S. Pat. No. 5,464,349 to Craig A. Andreiko et al. entitledOrthodontic Appliance Providing For Mesial Rotation Of Molars, each ofwhich is hereby expressly incorporated herein by reference. Many otherappliances and appliance components are available to orthodontists fromdifferent manufacturers.

Typically, the orthodontist studies the anatomy of the patient andconsiders the treatment plan to be prescribed. Then, the orthodontistselects standard brackets and other orthodontic appliance componentsfrom among the standard or pre-manufactured appliance componentsdescribed above. The appliance components selected are those deemed mostappropriate for the construction of an appliance in the form of a set ofbraces to be used to treat the patient in a manner most suited for thepatient.

According to certain embodiments of the present invention, rather thanthe orthodontist completely performing the analysis and selection ofappliance components, the orthodontist communicates details of thepatient's anatomy to an orthodontic appliance facility or a processingfacility, which analyzes the data and makes the selection for, or aidsin the selection by, the orthodontist of appliance components. Thecommunication may be in the form of data sent to the facility. The datamay be sent in any of several ways, including but not limited to digitaldata, digitally transmitted, acquired from digital scans of the patient,from visually acquired pictures or x-rays, or physically transmitted inthe form of a stone model or an impression.

In accordance with one preferred embodiment of the invention, physicalimpressions of the patient's dental arches are sent to the orthodonticappliance facility or data processing facility. The orthodontist mayalso make a stone model from the impression and transmit this to thefacility instead of or in addition to the impression. A prescription andother information may also be sent by the orthodontist. The receivingfacility may, if an impression is received, make a plaster cast or modelfrom the impression. The facility may then scan the model or impressionto produce three-dimensional data of the shapes of the patient's teeth,and may also produce data of the arrangement of the teeth in thepatient's mouth prior to treatment.

This and other data of the patient may then be input to a computer bythe orthodontic appliance or data processing facility operators, andsoftware is run on the data which may, wholly automatically orinteractively with an operator or technician, determine ideal positionsof the patient's teeth to be achieved as a result of proposed treatment.This may result in a calculated occlusion or setup or other digitizedmodel of the teeth in their post-treatment positions that may be furtherprocessed by, or sent to an appliance design facility, or returned tothe orthodontist.

From the digitized model of the ideal tooth positions, the informationis further processed at an appliance design facility to design a customorthodontic appliance particularly suited for the treatment of thepatient. The calculation may proceed in any of several ways, includingcalculating the geometry of a custom appliance without regard to thegeometries of pre-manufactured components. The appliance designcalculation results in calculated geometries for appliance components,including, for the more conventional type of appliance, geometries ofbrackets and archwires. These geometries are then compared with data ofthe pre-determined appliance component geometries to arrive atselections of components of those geometries for use in assembling theappliance for the patient.

The comparison may alternatively be achieved in the course of thecalculation by inserting the geometries of one or more of thepredetermined component geometries into the calculation and designing ofthe other components to best match the seeded values. Differentgeometries can be seeded and algorithms can be used to evaluate thegeometry of the resulting appliance to optimize the overall appliancebased on an optimal combination of component selections.

Examples of systems and methods for automatically designing customorthodontic appliances are described in U.S. Pat. No. 5,431,562 and inPCT Publication No. WO01/47405, discussed above and incorporated by,reference herein, but other automated set-up software has been describedor is available on the market, and may be suitable.

For example, software at the appliance facility may be used to calculateoperative parameters of the components of a custom appliance, which mayinclude, for example, the shape of an archwire or certain geometriccharacteristics of an orthodontic bracket, which are typically differentfor each tooth. A typical orthodontic bracket 10, for example, isillustrated in FIGS. 1–3. The bracket 10 includes a base or pad 11 thatis bonded with adhesive to a tooth 12. Archwire support structure 13 isintegrally formed with, or welded or otherwise fixed to, the pad 11.This support structure 13 is often formed of a pair of tie wings 14,having a rectangular archwire slot 15 formed therein in which anarchwire, usually also of rectangular cross section, may be mounted andheld with a ligature (not shown) that extends around the tips of the tierings. The archwire will have a curvature and lie in a plane 16.Comparable appliances to the bracket 10 include buccal tubes that areoften used on one of the molars on each side of each arch, in which thebase 11 is in the form of a tooth-encircling band and the supportstructure is in the form of an enclosed tube in which the tips of anarchwire are inserted.

Typical parameters that describe an orthodontic appliance are embodiedin the bracket 10, and may differ from patient to patient when a customorthodontic appliance is designed. One of these parameters is an in-outdimension 20, which may be defined as a distance to an archwire slot 15from a point on the bracket base 11 that bonds to the tooth 12 in theplane of the archwire 16. Another parameter is the torque or slotinclination angle 21, which is the angle of the archwire plane to a line19 normal to the surface of the tooth 12 where the base 11 is mounted. Afurther parameter is the tip angle 22, which is the angle between thearchwire and a line 18 normal to the axis of the tooth in themesial-distal direction. Still another parameter is the rotation angle23, which is the angle between the archwire and a line 17 normal to aplane bisecting the tooth in the mesial distal direction and in whichplane the tooth axis lies. These appliance parameters are more fullydefined in U.S. Pat. Nos. 5,431,562 and 5,533,895, hereby expresslyincorporated herein by reference, and other patents that have beenreferred to elsewhere herein.

In addition to the parameters discussed above, appliance placementinformation that defines the placement of an appliance component, suchas a bracket 10, is characteristic of a ideal custom appliance. Thesemay be defined to include horizontal and vertical offsets 28, 29 from apoint 24 at the center of the appliance base 11 to the center 25 of theface of the tooth 12 at which a standard appliance of the type 10 wouldcustomarily be mounted on the tooth 12. The position at which thebracket base is to be mounted to the tooth is a parameter calculated bymost custom appliance design software. Since the brackets being selectedare standard brackets that will be placed on the teeth by anorthodontist using conventional manual techniques, the bracket mountinglocations on the teeth at which the brackets are customarily placed istaken as given, at least initially in the appliance design calculations.Manual placement positions and techniques are described in the patentsdiscussed above and in U.S. Pat. Nos. 5,993,206 and 6,358,044 by CraigA. Andreiko entitled Visual Positioning Orthodontic Appliance andMethod, hereby expressly incorporated by reference herein.

According to one method of the invention, a custom orthodontic appliancedesign is calculated by a computer from data scanned from a model of thepatient's teeth and other data of the patient's anatomy and the customtreatment plan or prescription. The appliance design calculationtypically, in the automated custom appliance systems referred to aboveat least, is based on a calculation of custom finish positions of thepatient's teeth, often referred to as a custom set-up. The appliance isdesigned so that the archwire is supported in a stress-free state inbrackets mounted to the patient's teeth when the teeth arrive at thefinish positions of the calculated set-up.

The calculation may assume that orthodontic brackets will be placed onthese teeth in a conventional manner by the orthodontist, so that thecustom appliance design may be based on such bracket placementpositions. Then, with a custom archwire shape selected, the customarchwire geometry may be compared with the geometries of standardarchwire geometries and archwires for the appliance are therebyautomatically selected.

The calculated archwire shape and the positions of the teeth in thecalculated set-up are used to calculate the torque, tip, rotation andin-out parameters of the slots of brackets mounted in the assumedmounting positions. Alternatively, rather than use the calculatedarchwire shape, the shape of the standard archwire that was selected tobest approximate the calculated custom archwire shape may be used, whichwill reduce cumulative error. The resulting bracket parameters are thencompared to the parameters of available standard brackets and thestandard brackets that are the closest fit to calculated parameters areselected.

Alternatively, rather than select each bracket of the appliance that isthe best fit, the parameters of the selected brackets may individuallybe substituted for those of the corresponding calculated parameters ofthe custom bracket, and the appliance redesigned so that the customappliance uses the parameters of the standard bracket exactly. Then,different combinations of standard bracket parameters may be substitutedand the custom appliance redesigned then evaluated against somecriteria. In this iterative manner, an appliance that best uses the moststandard brackets with a minimum of difference between the standard andcalculated parameters can be selected. This method may also be used toadjust the appliance exactly to all but one or a few of the standardappliance components, leaving only the one or few to be customized torender the appliance fully custom.

Further, where the calculated parameters of one or more particularcustom brackets cannot be closely matched by any of the availablestandard brackets, a custom recommendation can be provided with thebracket selections to the orthodontist to aid the orthodontist inmodifying the placement or mounting of one or more brackets tocompensate for whatever error exists between the selected standardbracket and the custom bracket it is intended to simulate. For example,a recommendation might be made that the orthodontist mount a bracket acertain small distance mesial of the standard mounting position toproduce an adjustment to the slot rotation, or that the bracket betipped or mounted higher or lower in relation to the tip of the tooth toproduce a tip or torque adjustment.

Typically, tooth anatomy is sufficiently consistent from patient topatient that no comparison with standard brackets of different baseconfigurations is needed in order to fit brackets to the teeth. Usually,due to the relatively small bracket base sizes, the relatively smoothlycurved facial surfaces of the teeth can be accommodated by a single basecurvature for each given tooth. An exception to this is for the case ofbanded appliance bases, which are often used to mount buccal tubes tomolars, that may require different sizes to fit molars of differentsizes. Therefore, except for buccal tubes on molars, no selection needbe made based on a comparison of standard bracket parameters to toothsize or particular tooth dimensions. The selection may in most cases bebased only on a comparison of standard appliance geometric parameterswith those of a corresponding component of a custom appliance.

While it is preferred that: the selection be based on the scanning ofdata, the generation of three-dimensional images of each of thepatient's teeth, the calculation of a custom set-up, and the design of acustom orthodontic appliance therefrom, benefits of the invention can berealized in other ways. Interpretive information from the orthodontistbased on observations of the patient's anatomy or information regardinga prescribed treatment can be the basis for computer analysis from whichstandard appliance selection can be made to assist the orthodontist incarrying out an effective and efficient treatment plan. Theinterpretation of x-ray or photographic data or measurement data canalso lead to an intelligent selection of standard appliance componentsthat will more closely approximate an ideal custom appliance than mightotherwise be the case.

The method and system can be used to generate with a computer, from thevarious types of patient specific information provided, the physicalcharacteristics of custom appliance components for the patient, such ascustomized archwires, customized brackets, etc., and to present theorthodontist with the customized component characteristics or componentselection, or with a representation of the set-up or final toothpositions that such components would produce, providing the orthodontistwith the opportunity to specify modifications to the appliance, toothpositions or treatment, or to provide further input data for furtheranalysis and selection.

The invention may also be used to specify appliances that combinestandard brackets with custom archwires, or standard archwires withcustom brackets, or standard brackets with custom brackets, or for othercombinations of standard and custom appliance components. In this way,the customizing manufacturing operations can be confined to one or lessthan all of the appliance components, while still producing an appliancethat is at least partially custom and functions as well as, orapproaches the functions of, a custom appliance, at least to a degreethat is superior to a traditionally assembled appliance made up ofstandard components.

For purposes of the claims, the term “appliance” is used to refer toeither that which makes up the entire hardware to treat an orthodonticpatient or to one or more individual components of such hardware.

The invention has been described in the context of exemplaryembodiments. Those skilled in the art will appreciate that additions,deletions and modifications to the features described herein may be madewithout departing from the principles of the present invention.

1. A method of selecting orthodontic appliances comprising: providingdigital information that is a representation of individual dentalanatomy of a patient; analyzing the digital information with a computerto derive geometric parameters of a custom orthodontic appliance;comparing the derived geometric parameters with corresponding parametersof a plurality of alternative pre-manufactured orthodontic appliancesand selecting one of the plurality based on the comparison; wherein theproviding of the digital information includes any one of the following:a) forming a physical impression of a patient's teeth at a situs of anorthodontic practitioner, transporting the impression to an orthodonticappliance facility, forming at the orthodontic appliance facility asolid model of the patient's teeth from the impression, scanning themodel to produce three-dimensional digital information of the shape ofthe patient's teeth; b) digitizing skeletal information of the patient;c) digitizing soft tissue information of the patient; d) digitizingdental information of the patient other than as set forth in a); or e)digitizing x-rays of skeletal, soft tissue or dental information of thepatient; and wherein the analyzing of the digital information includesdesigning with a computer the orthodontic appliance that includes acustom orthodontic archwire and a set of custom orthodontic brackets tobe bonded to each of a plurality of the patient's teeth to support thearchwire to achieve an arrangement of the patient's teeth by orthodontictreatment.
 2. The method of claim 1 wherein the geometric parametersinclude slot in-out, slot torque, slot tip and slot rotation of each ofthe orthodontic brackets of the set.
 3. The method of claim 2 furthercomprising providing the selected appliance to an orthodonticpractitioner for treatment of the patient.
 4. The method of claim 1further comprising providing the selected appliance to an orthodonticpractitioner for treatment of the patient.
 5. A method of selectingorthodontic brackets comprising: forming a physical impression of apatient's teeth at a situs of an orthodontic practitioner; transportingthe impression to an orthodontic appliance facility; at the orthodonticappliance facility, scanning the impression or a model made therefrom toproduce three-dimensional digital information of the shape of thepatient's teeth; analyzing the three-dimensional digital informationwith a computer to derive an arrangement of the patient's teeth to beachieved by orthodontic treatment; designing with a computer a customorthodontic appliance that includes a custom orthodontic archwire and aset of custom orthodontic brackets to be bonded to each of a pluralityof the patient's teeth to support the archwire to achieve the derivedarrangement by the orthodontic treatment; comparing geometric parametersthat include slot in-out, slot torque, slot tip and slot rotation ofeach of the custom orthodontic brackets of the set with correspondingparameters of each of a plurality of standard or pre-manufacture redorthodontic brackets for a tooth and selecting one of the plurality ofstandard or pre-manufactured brackets based on the comparison; andproviding the selected brackets or information on the selection to anorthodontic practitioner for treatment of the patient.